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Double the Promise: Fetal Surgery for Twin-to-Twin Transfusion Syndrome

There are few occurrences more devastating for an expectant mother than being told that her unborn child is in danger. For Claudia Corriere, the impact was two-fold.

Corriere twins

Claudia Corriere discovered that she was expecting twins, but within ten days of the happy realization, she was dealt a distressing blow. Corriere was informed that her babies were suffering from a rare condition called twin-to-twin transfusion syndrome, also know as fetal transfusion syndrome, and the babies were at risk for serious birth defects or death.

Roughly twenty percent of identical twins will show evidence of twin-to-twin transfusion. The condition results in blood circulating from one fetus to the other. One twin is overextended by providing blood for two, resulting in decreased energy for growth and the production of less amniotic fluid. This can result in low birth weight, anemia, dehydration, high blood pressure and severe heart or brain problems. The recipient twin is at risk of developing heart failure, organ complications and brain damage as result of receiving an excess of blood and fluids.

Without treatment, the survival rate of both twins is less than ten percent. With the use of the traditional treatment of removing the excess amniotic fluid from the recipient twin, the statistics are better, at 26 percent. An early onset of twin-to-twin transfusion syndrome, before 20 weeks, is particularly dangerous, with high fatality rates. The gestation period of Corriere’s twins was barely at the 20-week mark, making the option of traditional treatment less promising.

Corriere was facing a staggering situation. It appeared that the best chance for survival of the twins was to undergo emergency fetal surgery. Corriere, a resident of Kennesaw, Georgia, was told that the best possible options were to be found out of state. Her physician recommended the Fetal Treatment Program of Hasbro Children’s Hospital, Women & Infants’ Hospital and Brown Medical School.

Corriere trusted her physician, but she was facing one of the most important decisions of her life. Though a center in Florida was closer to her home, Corriere concluded that her physician’s recommendation was the best option. She packed for a trip to Providence, Rhode Island.

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